<?php
	$ls_gridname	= 'detail_personal';


// ----------------- >> Form Detail << ----------------- ?>
<script type="text/javascript">
	$(document).ready(function(){

		// Setup Form
        $('#form_<?php echo $ls_gridname; ?>').setupForm([
        	{ name: 'no_ktp', type: 'text' },
            { name: 'id_gender_fk', size: 'medium', data:<?php echo json_encode(array_merge(array(array('value'=>'','display'=>'')),$listKelamin)); ?> },
            { name: 'tempat_lahir', type: 'text', size: 'short' },
            { name: 'tgl_lahir', type: 'date' },
            { name: 'alamat_jalan', type: 'textarea', size: 'medium', rows:2 },
            { name: 'alamat_surat', type: 'textarea', size: 'medium', rows:2 },
            { name: 'kode_pos', type: 'text' },
            { name: 'telepon_rumah', type: 'text' },
            { name: 'hp', type: 'text' },
            { name: 'email', type: 'text' },
            { name: 'golongan_darah', type: 'text' },
            { name: 'nama_orang_tua', type: 'text', size:'medium' },
            { name: 'id_agama_fk', size: 'medium', data:<?php echo json_encode(array_merge(array(array('value'=>'','display'=>'')),$listAgama)); ?> },
            { name: 'id_status_kawin_fk', size: 'medium', data:<?php echo json_encode(array_merge(array(array('value'=>'','display'=>'')),$listStatusKawin)); ?> },
            { name: 'id_country_fk', size: 'medium', data:<?php echo json_encode(array_merge(array(array('value'=>'','display'=>'')),$listCountry)); ?> }
        ], 
            <?php echo json_encode($data); ?>
        );
		
	});
</script>
<div id="form_<?php echo $ls_gridname; ?>_container" style="padding:5px;">
	<div id="form_<?php echo $ls_gridname; ?>">
    <!-- <input id="index_no" /> -->
    <table class="tb_form" border="0" style="width:100%;" cellpadding="0" cellspacing="0">
	    <tr>
	        <td class="label">No Identitas</td>
	        <td><input id="no_ktp" /></td>
	        <td width="50px"></td>
	        <td class="label">Alamat</td>
	        <td><input id="alamat_jalan" /></td>
	    </tr>
	    <tr>
	        <td class="label">Kewarganegaraan</td>
	        <td><input id="id_country_fk" /></td>
	        <td width="50px"></td>
	        <td class="label">Alamat Surat</td>
	        <td><input id="alamat_surat" /></td>
	    </tr>
	    <tr>
	        <td class="label">Kelamin</td>
	        <td><input id="id_gender_fk" /></td>
	        <td width="50px"></td>
	        <td class="label">Kode Pos</td>
	        <td><input id="kode_pos" /></td>
	    </tr>
	    <tr>
	        <td class="label">Agama</td>
	        <td><input id="id_agama_fk" /></td>
	        <td width="50px"></td>
	        <td class="label">Telepon Rumah</td>
	        <td><input id="telepon_rumah" /></td>
	    </tr>
	    <tr>
	        <td class="label">Status Kawin</td>
	        <td><input id="id_status_kawin_fk" /></td>
	        <td width="50px"></td>
	        <td class="label">Hp</td>
	        <td><input id="hp" /></td>
	    </tr>
	    <tr>
	        <td class="label">Tempat, Tanggal Lahir</td>
	        <td><input id="tempat_lahir" /> , <input id="tgl_lahir" /></td>
	        <td width="50px"></td>
	        <td class="label">Email</td>
	        <td><input id="email" /></td>
	    </tr>
	    <tr>
	    	<td class="label">Nama Orang Tua</td>
	        <td><input id="nama_orang_tua" /></td>
	    	<td></td>
	        <td class="label">Golongan Darah</td>
	        <td><input id="golongan_darah" /></td>
	    </tr>
    </table>
	</div>
</div>
<?php 
